ABSTRACT
Nonhealing foot ulcers in patients with diabetes are the leading cause of complications such as infection and amputation. This is a review of the traditional methods of good wound care for the diabetic foot ulcer. We also introduce newer methods for the treatment of these ulcers including hyperbaric oxygen therapy, bioengineered tissue, and recombinant platelet-derived growth factor-BB. By using a multidisciplinary team approach to care and integrating traditional and new wound-healing technologies, the goal of the US Department of Health and Human Services to lower the diabetic amputation rate by 40% may be achieved.
Subject(s)
Bandages , Diabetic Foot , Infections/etiology , Wound Healing/physiology , Counseling , Debridement , Diabetic Foot/complications , Diabetic Foot/etiology , Diabetic Foot/therapy , Humans , Hyperbaric Oxygenation , Patient Education as Topic , Peripheral Vascular Diseases/complicationsABSTRACT
Direction-changing nystagmus has been seen after the ingestion of ethanol in both animals and man. The direction of the nystagmus is dependent upon the position of the head and is thus called Positional Alcohol Nystagmus (PAN). This article provides information about positionally dependent, direction-changing nystagmus in human beings after the ingestion of glycerol (1.5 g/kg). Electronystagmographic recordings were made and serum glycerol levels were repeatedly determined over a period of 7 hours. The resulting data compliment earlier work done with ethanol. These data provide support for a buoyancy hypothesis to explain positional nystagmus after ingestion of water-soluble molecules with differing specific gravities.
Subject(s)
Glycerol/pharmacology , Nystagmus, Physiologic/drug effects , Adult , Electronystagmography , Glycerol/blood , Humans , Male , Middle AgedABSTRACT
This investigation was designed (1) to investigate further intermodulation distortion in hearing aids, and (2) to determine the effect of this type of distortion on speech intelligibility. After four hearing aids were analyzed for intermodulation distortion, 10 CID sentences were recorded through each instrument and presented to both normally hearing and sensorineurally impaired listeners. Results indicated an inverse relationship between levels of intermodulation distortion and frequency, with the highest distortion levels found below 1 kHz. This low-frequency distortion significantly interfered with speech intelligibility for sensorineurally impaired subjects listening to sentences in quite. For both the normally hearing group and the sensorineural group listening in noise, no significant differences were found. The results were interpreted to suggest that the low-frequency intermodulation distortion resulted in an upward spread of masking which interfered with perception of high-frequency acoustic cues in sensorineural impaired listeners; however, with the addition of a competing signal, the subtle masking effect of intermodulation distortion were obscured. Implications for additional research are discussed.
Subject(s)
Hearing Aids/standards , Hearing Loss, Sensorineural/rehabilitation , Perceptual Distortion , Speech Perception , Adult , Cues , Female , Humans , Male , Middle Aged , Perceptual MaskingABSTRACT
Aided threshold improvement obtained by 12 hearing-impaired children was compared to the acoustic gain of their hearing aids using both the traditional 2-cc coupler and a variable volume coupler designed to approximate real ear volume in children. Results indicated that acoustic gain determined in the 2-cc coupler underestimated aided threshold improvement by approximately 8.7 dB. Use of the variable volume coupler to determine acoustic gain, however, adequately predicted aided improvement at comfort setting. Use of the variable volume coupler in hearing-aid fittings for children is discussed with special emphasis on preventing over-amplification.
Subject(s)
Hearing Aids/instrumentation , Hearing Loss, Sensorineural/rehabilitation , Adult , Age Factors , Amplifiers, Electronic , Auditory Threshold , Child , Child, Preschool , Female , Humans , Male , MethodsABSTRACT
This study was designed to examine relationships between measures of total distortion (TD) and individual 2nd and 3rd harmonic distortion in various types of hearing aids. Measures of 2nd harmonic, 3rd harmonic, and TD were determined for six instruments. Analysis of the results revealed that little additional information is obtained from a measure of TD as opposed to individual harmonic measures. Furthermore, in two instances TD measures resulted in erroneously high distortion readings because of ambient and system noise. It is recommended that in less than ideal acoustic environments, measures of 2nd and 3rd harmonic distortion be used in lieu of TD.
